This panel will focus on the latest trends in contracting with pharmacy benefit managers (PBMs) and drug purchasing coalitions, including formulary and exclusionary list decisions, performance guarantees, managing rebates and discounts, the impact on employees, and audit rights. This panel will explore alternatives such as value-based insurance design, where high-value drugs cost patients less than low-value drugs, or payments based on the effectiveness of a drug. It also will highlight recent litigation against plans and pharmacy benefit managers concerning prices charged to employees.